Trichoscopic features of frontal fibrosing alopecia: Results in 249 patients

Fernández‐Crehuet, Pablo; Rodrigues-Barata, Ana Rita; Vañó‐Galván, Sergio; Serrano-Falcón, C.; Molina-Ruiz, Ana María; Arias‐Santiago, Salvador; Martorell, A.; Grimalt, Ramón; Garnacho‐Saucedo, Gloria; Serrano, Salvio; Moreno, J.C.; Jaén, Pedro; Camacho‐Martínez, F.

doi:10.1016/j.jaad.2014.10.039

Cited by 53 publications

(48 citation statements)

References 5 publications

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“…Our study demonstrates that the trichoscopic features of the sideburn region derail from the typical trichoscopic features of FFA, while the trichoscopic findings of the frontotemporal scalp are similar to previous studies [6,7]. In the current study, transparent proximal hair emergence was the most prominent finding in the sideburns (79.2%), and was not accompanied by peripilar casts, further supporting the noninflammatory pattern of FFA in this location.…”

Section: Discussionsupporting

confidence: 90%

“…Peripilar casts, also referred to as follicular hyperkeratosis, represent a concentrically arranged layer or layers of scale attached tightly around the emergence of the hair shafts. In two recent large trichoscopic studies, follicular hyperkeratosis was present in 90% of the 249 patients in the study by Fernandez-Crehuet et al [6] and in 72.1% of the 79 patients in the study by Toledo-Pastrana et al [7], followed by peripilar erythema in 66.3 and 77%, respectively. In the most recently published study on FFA including 242 patients from Spain, perifollicular erythema and hyperkeratosis was found in 114 patients (47.1%) at the frontal hairline and in 21 patients (8.7%) at the temporal hairline [8].…”

Section: Introductionmentioning

confidence: 99%

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Distinct Trichoscopic Features of the Sideburns in Frontal Fibrosing Alopecia Compared to the Frontotemporal Scalp

Cervantes

Miteva²

2017

Skin Appendage Disord

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The trichoscopic features of frontal fibrosing alopecia (FFA) have been described in the frontotemporal area, yet there is no data detailing the trichoscopic features of the sideburns, which can be the initial or exclusive area of involvement. In this retrospective cohort study, 236 trichoscopic images of the frontotemporal and sideburn area obtained via dry trichoscopy from patients with biopsy-proven FFA were examined by two independent researchers to determine the trichoscopic features of FFA in the sideburns. The images of the sideburns were compared to 44 trichoscopic images of 11 healthy volunteers with intact sideburns. Transparent proximal hair emergence surrounded by patches of paler smooth skin was the most prominent finding in the sideburns. Peripilar casts and peripilar erythema were rare in the sideburns compared to the frontotemporal area. Although less common, transparent proximal hair emergence was also seen in the sideburns of healthy controls, yet it was shorter and restricted to individual hairs. Early FFA presenting exclusively or mostly with sideburn involvement should not be missed due to absence of peripilar casts and peripilar erythema. Dermoscopy-guided biopsy obtained from hair shafts with transparent proximal hair emergence should be considered to make the diagnosis in this location.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Distinct Trichoscopic Features of the Sideburns in Frontal Fibrosing Alopecia Compared to the Frontotemporal Scalp

Cervantes

Miteva²

2017

Skin Appendage Disord

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“…In this case, trichoscopy showed features of FFA associated with a feature previously described in LSC – broom hair fibers [3, 8]. As was the case in another report, the absence of other trichoscopic features of TTM and the presence of lichenification distinguishes LSC from TTM.…”

Section: Answersupporting

confidence: 75%

“…Trichoscopic findings include the absence of follicular openings and vellus hair in the frontal hairline, follicular hyperkeratosis, perifollicular scaling, and erythema [8]. Histopathological features include inflammatory lymphocytic infiltration localized around the isthmus and concentric perifollicular fibrosis [9].…”

Section: Answermentioning

confidence: 99%

Cicatricial Alopecia with Particular Trichoscopic and Histopathological Features

Rocchetto

Fechine

Anzai

et al. 2018

Skin Appendage Disord

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“…Currently, trichoscopy has become increasingly popular for the diagnosis of different types of scarring alopecia and has shown to be useful in evaluating the activity, progression, and treatment response of FFA [6]. Trichoscopic features of FFA include loss of follicular openings, loss of vellus hairs, peripilar casts, black dots, broken hairs, and pili torti [11].…”

Section: Introductionmentioning

confidence: 99%

Frontal Fibrosing Alopecia Severity Index: A Trichoscopic Visual Scale That Correlates Thickness of Peripilar Casts with Severity of Inflammatory Changes at Pathology

Martínez‐Velasco¹,

Vázquez-Herrera²,

Misciali³

et al. 2018

Skin Appendage Disord

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Background: Frontal fibrosing alopecia (FFA) is a scarring alopecia that mainly affects postmenopausal women characterized by recession of the frontotemporal hairline and eyebrow loss. Current techniques to assess FFA activity are limited and involve noninvasive tools that assess disease progression or an invasive technique such as scalp biopsies. However, since progression of FFA is very slow, it is very important to develop a noninvasive technique to assess disease activity to monitor treatment response. Objectives: To provide a standardized and objective method to assess FFA activity. Methods: We evaluated the correlation between trichoscopy and pathological features (degree of lymphocytic infiltration) in 20 dermoscopy-guided biopsies of FFA. At trichoscopy, we divided the severity of peripilar casts into 3 grades according to their thickness. To validate the trichoscopic visual scale, we showed the images to 7 dermatologists with interest in hair diseases. Concordance was assessed using the Kendall Tau-b concordance test. Results: A strong correlation between severity of peripilar casts at trichoscopy and degree of lymphocytic infiltrate was observed by the Kendall Tau-b test. Validation showed very good inter- and intraobserver agreement. Conclusion: The trichoscopic visual scale allows noninvasive assessment of scalp inflammation in FFA in different scalp regions and therefore provides optimal guidance for treatment.

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Trichoscopic features of frontal fibrosing alopecia: Results in 249 patients

Cited by 53 publications

References 5 publications

Distinct Trichoscopic Features of the Sideburns in Frontal Fibrosing Alopecia Compared to the Frontotemporal Scalp

Distinct Trichoscopic Features of the Sideburns in Frontal Fibrosing Alopecia Compared to the Frontotemporal Scalp

Cicatricial Alopecia with Particular Trichoscopic and Histopathological Features

Frontal Fibrosing Alopecia Severity Index: A Trichoscopic Visual Scale That Correlates Thickness of Peripilar Casts with Severity of Inflammatory Changes at Pathology

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